Abstract

The supply of veterinary drugs
in Uganda is solely carried out by the private sector. This study evaluated the
prices of animal drugs, availability, affordability and its impact on livestock
enterprise survival in central Uganda. The cross-sectional study was carried out
in Mityana district from January to March 2010. One hundred farmers reporting to
four selected animal drug shops were interviewed and these included 49% small
holder farmers, 36% and 15% large and medium holder farmers, respectively.

Of
the 282 drug purchases, 31% (88) were antihelmintics while antimicrobials and
acaricides constituted another one-third of the purchases. The majority (75%) of
the farmers could not afford the prices and these mostly included essential
veterinary drugs such as acaricides, antimicrobials, de-wormers and drugs for
treatment of tickborne diseases. Seventy-two percent of the farmers reiterated
that high drug prices reduce their livestock enterprise profitability and
survival. Due to increased drug prices, 63% of the farmers devised coping
methods which included change to cheaper alternatives (32%), reduced the dosage
(16%), reduced the period of treatment period or abandoned the treatment regime
(1%). Eighty-nine percent of the farmers wanted the government to regulate the
prices of veterinary drugs. In conclusion, the high price of veterinary drugs
especially to commercial farmers due to lack of price control by the government
impacts negatively on livestock enterprise survival, profitability and rational
use of veterinary drugs. Therefore, the government needs to consider reducing
tariffs levied on importation of veterinary pharmaceuticals to reduce the priced
burden on livestock farmers.

Introduction

Significantly, livestock are source of income, store of wealth and social
security as well as ensuring food security, provision of draught power and
manure for smallholders in sub-Saharan Africa (FAO 1998). In Uganda, the
livestock sub-sector contributes 12.7% and 5.2% to agricultural GDP and total
GDP, respectively. This sector continues to grow at a rate of over 4% per annum
due to increasing demand for milk and meat (Uganda Investment Authority 2005).
The majority of households engaged in livestock agriculture have shown
resilience, higher incomes and faster rates of overcoming poverty than
crop-based households in Uganda (FAO 2003). What African agriculture needs is a
viable productive livestock industry to achieve optimum growth for her
impoverished rural communities. However, the economic viability of the livestock
sub-sector is continuously threatened by high prevalence of infectious, vector
borne and parasitic diseases (FAO 2005). This necessitates the use of veterinary
drugs and pesticides for prevention, control and treatment towards improvement
of livestock productivity.

Efficient and reliable animal
health services constitute an essential prerequisite to livestock development in
Sub-Saharan Africa (FAO 1996). Most African countries including Uganda have
privatized their veterinary services in order to enhance efficient productivity
of the livestock sector for the benefit of the producer, the veterinarians,
animal agriculture and national economies (Mpelumbe
1994; De Haan and
Bekure 1991). In countries with
successful privatization programs such as Morocco, there is improved provision
of veterinary services (Holden 1999) and supply and availability of animal drugs
(Daniels and Skerman 1993; Holden 1999).
Nonetheless, in many developing countries animal drugs
have variable prices, often high in relation to income levels
of farmers. No pricing policies or regulation mechanism for the private-sector
drugs pricing system for veterinary drugs exist in Uganda (National Drug
Authority 1993). In contrast, however, the pricing by
pharmaceutical companies or distributors in South Africa for instance, depends
on standardized price lists, with bulk discounts and sliding scales on over the
counter products (Dijk 2008). Similarly, in Australia, Canada and the United
Kingdom mechanisms for setting, monitoring, regulating and reviewing of drug
prices so as to keep them at reasonable levels are well established (WHO 2009).

The
distribution chain of veterinary drugs in Uganda can broadly be categorized
into; sole distributors (importers), regional distributors (regional pharmacies)
and retail outlets (drug shops) which interface mostly with rural livestock
farmers. In the rural pastoral communities, the pharmaceutical companies focus
on selling dewormers, ectoparasiticides, antibiotics and vaccines with a
restricted number of packed sizes available (Dijk 2008). If any, there is
minimal price regulation along the supply chain, hence the drugs shops prefer
the sale of lower priced generic drugs from where they generate higher profits
compared to higher priced products. Although the generic drugs are a ‘hot cake’
in most rural pastoral communities because of the affordable prices, their
quality is relatively lower than innovator drugs. Such products may lead to the
emergence of microorganisms resistant to drugs in man and animal, residues in
milk and meat, chronic disease and death (Owens 2003).

In Uganda, veterinary drug
pricing, availability and affordability by livestock farmers have not been
studied. Hence this study aimed at evaluating the pricing on the availability
and affordability of veterinary drugs and its impact on the survival of
livestock enterprises in central Uganda.

Methods

The study was carried out in
the central Uganda district of Mityana, which lies within the cattle corridor.
Veterinary services are provided by both government
veterinary staff, private veterinarians and other professionals working with
non-governmental organizations.

Study design and population

This was a
cross- sectional descriptive study involving the participation of farmers in
Mityana district from January to March 2010. Four retail veterinary drug shops
which sold a variety of animal drugs and mostly frequented by livestock farmers
in Mityana town were selected as study sites for the collection of data. The
target population was livestock farmers purchasing veterinary drugs from any of
the four drug shops between January and March 2010. During these periods,
questionnaires were filled for all farmers reporting between 9.00am-2.00pm on
three consecutive days of each week.

All
livestock farmers who visited the selected drugs shops and bought animal drug
during the time of the interview were included. All farmers who visited the drug
shop for other reasons, other than buying animal drugs were excluded from this
study.

Results

Demographic information and categories of farmers

A total of
100 livestock farmers participated in this study. Forty-one percent of farmers
had primary education, 27% had Uganda certificate of education, 10% had Uganda
advanced certificate of education and 22% had attained a diploma or above. The
farmers were categorized into smallholder, medium and large-scale holder farmers
depending on the number of animals as shown in Table 1. Forty nine (49%) of the
farmers were smallholder farmers, while 36% and 15% were large and medium
holders, respectively (Table 1).

Table 1. Types of farmers and the range of
animals kept

Type of farmer

Cattle

Goats/sheep

Chicken

Total/percentage

Small holder farmer

<6

<6

<50

49

Medium holder farmer

<6-30

>6

>50-300

15

Large holder farmer

>30

>6

>300

36

Total

100

The small
holder farmers kept their animals in the backyard of the homestead. The cattle
and goats were tethered around home, while pigs were tied with ropes around
trees. The birds were local scavenging chickens which were often prone to
predation. The medium and large holder livestock farmers grazed their cattle in
paddocks or rangeland. The pigs were housed and provided with feeds mainly
composed of leftovers and crop residues, while chickens were reared both under
free range system and confinement.

Veterinary drug pricing

Antitheilerial drugs were the most expensive per unit pack. A bottle of
Buparvaquone (40 mls ButalexTM) and Parvaquone (100 mls Parvexon®)
costs 90,000 and 70,000 Uganda shillings (Ug.Shs) respectively. A 100 mls bottle
of antibacterials
costs a minimum of 6,000 Ug.Shs while a litre of acaricide
would cost atleast 60,000 Ug.Shs. The above drugs are also dispensed in
small quantities such as 1 ml to those who can not afford a whole vial or
bottle. Such clients are mainly small holder farmers who pay between 100 and 500
Ug.Sh for 1 ml of the various categories of drugs that are sold (Table 3).

Table 3. Prices of selected
Veterinary drugs in Mityana district (Exchange rate
for the Uganda Shillings against the United State Dollar: 1 US dollar = 2,200
Uganda Shillings)

Category of Drug

Drug

Trade Name

Dosage form

Quantity in the original Pack

Price of Original Pack
(Uganda Shillings)

Price of Small quantities
(1ml) [Uganda Shillings]

Antibacterials

Oxytetracycline

Alamycin 10%

Injectable

100
mls

6,000

100

Oxytetracycline

Alamycin 20%

Injectable

100
mls

7,000

200

Oxytetracycline

OTC20

Powder

100 g

6,000

Nil

Penicillin-Streptomycin

PenStrep

Injectable

100
mls

6,000

Nil

Trimethroprim-Sulfadiazine

Norodine

Injectable

100
mls

9,000

Nil

Anthelmintics

Ivermectin

Noromectin

Injectables

50 mls

14,000

500

Albendazole

Albafas 10%

Drench

1
liter

20,000

100

Piperazine

Ascarex

Powder

30 g

2,000

Nil

Levamisole

Wormicid

tablets

1
tablet

700

Nil

Acaricides

Cypermethrin

Alfarpor

Topical

1
liter

60,000

100

α-Cypermethrin

Tsetse
tick

Topical

250
mls

21,000

100

Cypermethrin

Renegade

Topical

250
mls

20,000

100

Amitraz

Amitix

Topical

1
liter

50,000

100

Antitheilerials

Buparvaquone

Butalex

Injectable

40 mls

90,000

2,500

Parvaquone

Parvexon

Injectable

100
mls

70,000

1,000

Anticoccidials

Furazolidone

Fuzol

Powder

5 g

1,000

Nil

Amprolium

Amprosulf

Powder

100 g

8,500

Antitrypanosomes

Diminazene aceturate

Diminakel

Powder

2.36 g
sachet

1,000

Nil

Mineral and Vitamins

Mineral Block

Agrilik

Block

2 kg

6,000

Nil

Iron

Ferurum +B12

Injectable

100
mls

18,000

Nil

Multi-vitamins

Multivit

Injectable

100
mls

5,000

Nil

Affordability of animal drugs

Out of the 100 farmers, only 25% could afford the prices of the drugs, while the
majority (75%) could not afford (Table 4). Only 41% of the smallholder farmers
could afford the prices of animal drugs compared to 51% who could not afford the
prices. Only 7% and 11% of the medium and large scale farmers could afford
the the prices of drugs (Table 4).

Table 4. Affordability of veterinary
drugs among diffeerent categories of livestock farmers in Mityana
district

Animal drug prices
affordability

Category of farmer

Affordable

Not affordable

Total

Number and percentage

Small holder

20[41]

29[59]

49

Medium scale

1[7]

14[93]

15

Large scale

4[11]

32[89]

36

Total

25

75

100

About 80% of
the smallholder farmers could afford the prices of the drugs compared to the
medium and large holder farmers (P = 0.002) because they purchased drugs in
smaller quantities. The most affordable drugs were wormicid®
(levamizole) and small quantities of acaridies and antibiotics (Table 5).

Table 5.
Types of affordable drugs to different categories of farmers

Types of affordable
animal drugs

De-worming tablets

Sachets of trypanocidals

Measurable Quantities of

Category of farmer

Wormicid No.[%]

Piperazine
No.[%]

Berenil
No.[%]

acaricides and antibiotics

Total
No.[%]

Small holder

9[36]

4[16]

2[8]

7[28]

22[88]

Medium scale

0

0

2[8]

0

2[8]

Large scale

0

0

0

1[4]

1[4]

Total

9[36]

4[16]

4[16]

8[32]

25[100]

Categories of unaffordable drugs reported by farmers

Of the 75
farmers that could not afford the high prices of drugs, the majority 64/75 (85%)
could not afford acaricides (25%), antimicrobials (24%), de-wormers (20%) and
drugs for treatment of tickborne diseases (16%) as shown in Figure 1. The
remaining 15% could not afford trypanocidals (10%) or anticoccidial drugs (5%).
There was no significant difference between type of drug and unaffordability
(p>0.05).

Figure 1.
Categories of unaffordable drugs reported by
farmers

Coping
strategies for high drug prices

In case of increased
drug prices, only 37% of the farmers continued using the same drugs, while the
majority of farmers (63%) sought for another alternative. Of those who sought
for alternatives, slightly more than half (32, 51%) changed to cheaper drugs, 20
(32%) opted to reduce the dosage (quantities) of the administered drugs, 10
(16%) decreased the period of treatment period, while 1(1%) withdrew and
abandoned the treatment (Figure 2). The coping mechanisms in response to high
drug prices are practiced mainly by large holder farmers (47%) and medium holder
farmers (35%) than small holder farmers (18%).

Drug pricing and the survival of the
livestock enterprise

Seventy two
percent of the farmers noted that high drug pricing affected their livestock
enterprises and survival. Of these 36 (50%) were large holder farmers, 27 (37.5%)
medium holder and small holder 9 (12.5%). The effect of high drug prices was
affecting the survival of medium and largeholders than small holder enterprises
since the cost of production is increased.

Perceived role of government in regulation of
veterinary drug pricing

The majority
of farmers (64 of 72, 89%) who could not afford the drug prices, said they
wanted the government to regulate prices of veterinary drugs, whereas 8 (11%) did
not expect government to regulate drug prices. Of the 64 farmers, 31 (48%) were
large scale holders, 23 (36%) medium holder and 16% (10) small holders.

Discussion

The
majority of respondents (41%) had primary education. This was not surprising
because most rural farmers in Uganda are not educated, thus they concentrate on
livestock and crop farming as a source of income. Many farmers (47%) had spent
above four years in livestock production, this could be attributed to various
benefits they derive from livestock enterprise for their livelihood. This
finding is in agreement with a previous report (Plan for Modernization of
Agriculture 2004) which showed that 80% of the Uganda’s population depends on
agriculture production.

The animal
drugs sold in Mityana District were mainly over the counter/class C drugs and
few class B drugs such as antibiotics, anti-trypanosomes and drugs for treatment
of tick-borne fevers. This is due to the high demand for such drugs by farmers
for treatment and prevention of the common livestock diseases such as
helminthes, tick borne diseases, bacterial diseases, and trypanasomiasis, which
are the major livestock diseases of economic importance in Uganda. There is
minimal if any restriction on the distribution and sale of prescription drugs.
As such antimicrobials can be accessed by farmers without any prescription. Such
a practice could predispose to irrational use of drugs with both animal health
and public health implications. The high purchase of dewormers could probably be
attributed to the high prevalence of helminthes in the district. Dewormers are
used for both prophylactic and curative treatment of livestock helminthes. This
finding is in agreement with previous studies which reported huge amount of
money spent annually on deworming livestock (Tisdell et al
1999).

Seventy-five
percent of the farmers suggested that drugs were expensive. This is expected
because the private sector aims at making exorbitant profits disregarding the
income levels of the farmers. This finding is in contrast with the veterinary
drug policy in Uganda which aims to support and promote the availability and
accessible of cost-effective veterinary drugs (National Veterinary Drug Policy
2002). This is partly because the policy has not been implemented. Thus, in
Uganda, the private sector sets prices that a market can sustain depending on
the demand and supply of the drugs. The high prices in Uganda are similar to
high prices reported in other developing nations (OIE 2004), where animal drugs
have variable prices. The
categories of expensive drugs included acaricides, dewormers, antibiotics,
antithelerials and anticoccidials. These drugs are important in the treatment
and prevention of the prevailing livestock diseases in Uganda; hence they are
highly demanded by both small holder and commercial farmers. High cost of
drugs may lead to ineffective treatment regimen and prevention of livestock
diseases, predisposing animals to high mortalities, and loss of farm profits and
eventual collapse of the livestock enterprise.

Interestingly, of 25% of the farmers who could afford the prices of drugs were
able to buy drugs in form of tablets, sachets and and measurable quantities of
acaricides and antibiotics. The reason as to why the smaller holder farmers were
able to afford the prices of drugs as compared to the medium and large scale
farmers is because they purchased repackaged drugs in smaller quantities at
lower cost. The high demand for smaller quantities of the drugs due to their
affordability has compelled drug shop owners to repackage drugs to meet the
clients’ preferences. Such unacceptable practices predispose to
adulteration of drugs and of compromise the efficacy and safety. The large and
medium holder farmers could not afford the drug prices because they require
large quantities of drugs for routine control and prevention of livestock
diseases. Our study seems to suggest that drug availability and use per animal
is lower in Mityana district. This contrasts with previous studies in several
countries where privatization of veterinary services and drug supplies has led
to increase in drug supply and use (Daniels and Skerman
1993; Holden 1999).

Because of
high price of animal drugs, most farmers have been compelled to devise
strategies for survival of their livestock enterprises. Such measures include
buying cheaper drugs, reducing treatment interval or reducing the dosage of drug
administered to animals. The sources of cheaper animal drugs in rural
communities include vendors, cattle markets and road side shops along cattle
routes. Such drugs are often expired and of doubtable efficacy. Reducing the
treatment interval or the dosage of drugs constitute irrational use of drugs and
may lead to emergence of microbial agents with drug resistance to antibacterial
and antiparasitic drugs. The public health consequences of such acts should not
also be ignored. The residual effects of drugs in food of animal origin stemming
from irrational use of drugs can compromise quality of animal products thus
affecting international trade of livestock products.

In this
study, 89% of the farmers said that the government could play a role in the
regulation of drug prices. This was not surprising because privatization of
veterinary services has received mixed reactions among the farming communities
in Africa (de Haan and Bekure 1991).
However, the farmers’ perceptions were contrary to the government’s mandate,
since under a privatized drug system the role of the government is relegated to
ensuring efficacious and safety of drugs in the market (National Veterinary Drug
Policy 2002). Noteworthy, there is need for Uganda government to ensure that
prices of animal drugs are regulated and in tandem with the market values as has
been practiced elsewhere (Dijk 2008; WHO 2009). This is recognition of the
important role the livestock sector plays in alleviating poverty for many rural
households (FAO2003).

In
conclusion, all livestock drugs used in Uganda are imported and therefore any
form of subsidy which could reduce the prices of drugs would reduce the cost of
farm inputs, promote rational use of drugs, survival and profitability of
livestock enterprises leading to improved livelihoods.

Acknowledgement

The authors
would like to acknowledge Veterinary drug shop owners and livestock farmers in
Mityana town in Mityana district.The role of Dr.
Charles Lagu in reviewing this paper is highly appreciated

FAO (Food and Agriculture Organization) 2003
Impact of Changing Market Forces and Policies on Structural Change in the
Livestock Industries of Selected Fast-Growing Developing Countries: Final
Research Report of Phase I - Project on Livestock Industrialization, Trade and
Social-Health-Environment Impacts in Developing Countries. Food and
Agricultural Organization of the United Nations, Rome Italy.

FAO (Food and Agriculture Organization) 2005
Trypanotolerant livestock in the context of trypanosomiasis intervention
strategies. Food and Agriculture of the United Nations, Rome Italy.

Mpelumbe I S 1994 Perspectives
on the privatization of the veterinary practice in the livestock production in
Africa. Repports de synthes surles themes techniques presentes all comite
international aui aux commissions regionales, 1993: pp 73-87.